Week 1: Articles Flashcards
What disorders does the Heutink study focus on?
Visual agnosia and Balint’s syndrome.
What is the main goal of the Heutink study?
To explore rehabilitation strategies for visual agnosia and Balint’s syndrome.
How many studies were included in the review?
22 studies published between 1992 and 2017.
What types of techniques are compared in the study?
Compensatory strategies vs. restorative training.
What is the impact of visual perceptual disorders?
They affect spatial orientation, learning, motor activities, and reduce independence and social participation.
What percentage of ABI patients experience higher visual disorders?
20-40%.
What are the two main goals of visual rehabilitation?
Restore function or compensate using intact functions.
How many studies on Balint’s Syndrome were reviewed?
10 studies (7 case studies and 3 recommendations).
What are common compensatory strategies for Balint’s Syndrome?
Psychoeducation, environmental adaptation, and structured training.
What is the effectiveness of restorative training for Balint’s Syndrome?
Results were inconsistent.
How many studies on prosopagnosia were reviewed?
8 studies.
What is a common compensatory strategy for prosopagnosia?
Using non-facial cues like voice, gait, or hairstyle.
What is a key limitation of restorative training for prosopagnosia?
Limited success in improving real-life face recognition.
How many studies addressed object agnosia?
7 studies.
What are common compensatory strategies for object agnosia?
Using tactile, auditory, and kinaesthetic cues.
Was restorative training effective for object agnosia?
Some showed improvement, but results were inconsistent.
How many studies addressed topographical agnosia?
Only two studies.
What strategies were effective for topographical agnosia?
Mnemonic techniques and route training.
Which strategy is generally more effective: compensatory or restorative?
Compensatory strategies.
What factors influence rehabilitation effectiveness?
Etiology, individualization, patient motivation, and co-occurring deficits.
What is a major recommendation for future research?
Document case studies with pre/post assessments and explore new cognitive tools.
What should future studies assess regarding training outcomes?
Whether trained skills transfer to real-life improvements.
What condition does prism adaptation (PA) aim to treat?
Visual neglect, often caused by right hemisphere strokes.
How does prism adaptation therapy work?
Patients wear goggles shifting their visual field 10° right, inducing reaching errors corrected through repeated attempts.
How were patients classified as high or low responders in the study?
High responders showed >20% improvement in neglect symptoms; low responders showed <20% improvement.
What anatomical factors were studied to predict PA effectiveness?
Cortical thickness and white matter integrity in the left hemisphere.
Which areas had less damage in high responders?
Right inferior parietal lobule, postcentral gyrus, and frontal cortex.
Which areas had more damage in low responders?
Right supramarginal and angular gyri.
What was associated with better PA outcomes in terms of cortical thickness?
Higher cortical thickness in the left temporo-parietal and prefrontal regions.
What white matter feature predicted PA success?
Higher fractional anisotropy in the corpus callosum.
What does the study suggest about early PA intervention?
Earlier PA after stroke improves outcomes and may prevent long-term neural deterioration.
What is a limitation of the study?
Small sample size limits generalizability; pre-existing brain atrophy may confound results.
What are the clinical implications of the study?
Rehabilitation strategies should be personalized based on anatomical and functional brain characteristics.
What neuroimaging technique was used to assess white matter integrity in the study?
Fractional anisotropy (FA) in the corpus callosum
Which neuropsychological tests were used to assess neglect severity?
Letter cancellation, line bisection, and drawing tasks
How many patients were included in the Lunven study?
14 patients
What visual shift did the prismatic goggles induce during therapy?
A 10° rightward visual field shift
What defined a ‘high responder’ in the study?
Patients showing more than 20% improvement post-prism adaptation
Which brain regions had less damage in high responders?
Right inferior parietal lobule, postcentral gyrus, and frontal cortex
What role does the left hemisphere play in recovery from neglect?
It acts as a compensatory mechanism aided by cortical thickness and connectivity
Why is early intervention with PA crucial post-stroke?
It helps recovery before irreversible neural deterioration occurs
What was a major limitation of the Lunven study?
Small sample size limiting generalizability
What anatomical characteristic was linked to low responsiveness to PA?
Greater white matter degeneration and larger lesion volumes
What is definition of apraxia?
Inability to perform learned movements despite intact motor function, sensation, and coordination.
What is liepmann’s theory?
Motor planning occurs in the left motor cortex; execution involves occipital and parietal lobes.
What is geschwind’s theory?
Apraxia results from disconnection between left premotor cortex and Wernicke’s area.
What is buxbaum’s model?
Involves left frontal and inferior parietal lobules; integrates object representation and body awareness.
What is ideomotor apraxia?
Inability to perform gestures on verbal command despite understanding the action.
What is ideational apraxia?
Impairment in conceptualizing a sequence of actions despite recognizing tools.
What is limb-kinetic apraxia?
Loss of precise, coordinated hand movements.
What is apraxia evaluation - de renzi test?
24-item scale assessing gesture execution.
What is apraxia evaluation - tulia?
48-item assessment including symbolic, intransitive, and transitive gestures.
What is ast (apraxia screen of tulia)?
Short bedside version with high sensitivity and specificity.
What is pegboard test?
Used to assess limb-kinetic apraxia.
What is brain regions in apraxia?
Involves parieto-premotor-frontal network.
What is ideomotor apraxia lesions?
Left premotor cortex, inferior parietal lobe, and corpus callosum.
What is ideational apraxia lesions?
Left premotor, prefrontal, and parietal areas.
What is limb-kinetic apraxia lesions?
Contralateral premotor cortex.
What is gesture-based training?
Improves praxis and daily function.
What is task-based training?
Enhances goal-directed actions using real tools.
What is tdcs for apraxia?
Improves gesture processing; applied to left parietal or right motor cortex.
What is rtms for apraxia?
Potential in Alzheimer’s and stroke; clinical trials still needed.
What is tbs for apraxia?
Shorter stimulation period; needs further research.
What is key future directions?
Standardize tests, explore stimulation, study long-term effects.
